"Lord, we ask that this project come in under budget," said the Rev. John Chesser, pastor of Calvary Assembly of God, who kicked off the groundbreaking of Pasco Regional Medical Center's emergency room expansion Wednesday. After asking that it also be finished on time, that it not interfere with daily operations, that it be completed safely and that the leaders be given wisdom and the ability to combine medicine and faith, Chesser wrapped it up with an "Amen."

"I've never had anyone ask for a project to come under budget," hospital administrator Gary Lang joked in his remarks afterward. "But I really appreciate that."

The groundbreaking put Pasco Regional in the parade of county hospitals expanding buildings or upgrading services.

Staffers in white coats and scrubs took photos as Dade City Mayor Scott Black and executives from the hospital and its parent company, Naples-based Health Management Associates, shoveled symbolic dirt while standing in front of a yellow construction vehicle.

Health Management chief executive officer Gary Newsome borrowed a page from the president's State of the Union speech playbook when he recognized labor and delivery nurse Sharon McKendree.

"She's a great representative for all the associates," he said, noting that patient comments described her as "absolutely amazing." McKendree had no idea she'd be called to the lectern. It was supposed to have been her day off, but she got called in because of some extra births.

"I was dropping off two kids at school," said McKendree, who was still wearing blue jeans.

The project, which will be built in three phases, begins with the addition of 8,400 square feet to the existing 4,300-square-foot emergency room. The space will include 17 exam rooms, including some geared toward children. Also in Phase 1 will be an imaging suite, decontamination zone, triage station, nurses' station, EMS lounge and a guest lounge. The outside will include designated EMS bays and a canopied area for public access.

Phases 2 and 3 will include renovating the existing ER with consultation suites, a staff lounge, nurses's station and storage space.

The project begins a year after Morton Plant Hospital North Bay in New Port Richey completed a major expansion that included a renovation of its ER. Also, Florida Hospital Zephyrhills recently hired a new board-certified team of physicians to staff its ER. (The old team ended up at Pasco Regional, which Lang described as "our gain.") And construction is well under way for Community Hospital in New Port Richey to move to a new facility on State Road 54 in Trinity at the end of the year. In December, crews began building Florida Hospital Wesley Chapel, an 80-bed facility with the capacity to expand to about 300, on Bruce B. Downs Boulevard on part of the Wiregrass Ranch.